Factors underlying regression of coronary atheroma with potent statin therapy

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dc.contributor.authorPuri, R.
dc.contributor.authorNissen, S.
dc.contributor.authorBallantyne, C.
dc.contributor.authorBarter, P.
dc.contributor.authorChapman, M.
dc.contributor.authorErbel, R.
dc.contributor.authorLibby, P.
dc.contributor.authorRaichlen, J.
dc.contributor.authorSt. John, J.
dc.contributor.authorWolski, K.
dc.contributor.authorUno, K.
dc.contributor.authorKataoka, Y.
dc.contributor.authorNicholls, S.
dc.date.issued2013
dc.description.abstractAIMS: Statins can inhibit the progression of coronary atherosclerosis. We aimed to characterize clinical factors that associate with differing measures of coronary atheroma volume following potent statin therapy. METHODS AND RESULTS: SATURN employed serial intravascular ultrasound (IVUS) to monitor changes in measures of coronary atheroma burden [total atheroma volume (TAV) and per cent atheroma volume (PAV)] in 1039 patients with coronary artery disease, treated with rosuvastatin (40 mg) or atorvastatin (80 mg) daily for 24 months. Rosuvastatin-treated patients demonstrated greater reductions in low-density lipoprotein cholesterol (LDL-C, 47 vs. 40%, P < 0.001) and greater increases in high-density lipoprotein cholesterol (HDL-C, 13 vs. 10%, P = 0.02). These alterations in the lipid profile associated with greater TAV (−6.4 vs. −4.4 mm3, P = 0.01), but not PAV (−1.22 vs. −0.99%, P = 0.17) regression. Greater TAV reductions with rosuvastatin vs. atorvastatin occurred in patients with diabetes (P = 0.01, treatment by diabetic status interaction P-value 0.05). Greater PAV reductions with rosuvastatin were evident in females (P = 0.01, treatment by sex interaction P-value 0.03) and in those with greater than or equal to median baseline LDL-C (P = 0.02, treatment by LDL-C group interaction P-value 0.03) or HDL-C levels (P = 0.02, treatment by HDL-C group interaction P-value 0.04). On multivariable analysis assessing change in TAV and PAV, both higher baseline TAV and PAV independently associated with TAV and PAV regression, respectively (standardized estimates: TAV −0.25, P < 0.001; PAV −0.23, P < 0.001). CONCLUSION: Higher-risk patients, particularly those with greater baseline coronary atheroma volume, are more likely to experience less disease progression with potent statin therapy.
dc.description.statementofresponsibilityRishi Puri, Steven E. Nissen, Christie M. Ballantyne, Phillip J. Barter, M. John Chapman, Raimund Erbel, Peter Libby, Joel S. Raichlen, Julie St. John, Kathy Wolski, Kiyoko Uno, Yu Kataoka and Stephen J. Nicholls
dc.identifier.citationEuropean Heart Journal, 2013; 34(24):1818-1825
dc.identifier.doi10.1093/eurheartj/eht084
dc.identifier.issn0195-668X
dc.identifier.issn1522-9645
dc.identifier.orcidPuri, R. [0000-0001-8849-7426]
dc.identifier.orcidNicholls, S. [0000-0002-9668-4368]
dc.identifier.urihttp://hdl.handle.net/2440/79415
dc.language.isoen
dc.publisherW B Saunders Co Ltd
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/565579
dc.rightsPublished on behalf of the European Society of Cardiology. All rights reserved. & The Author 2013
dc.source.urihttps://doi.org/10.1093/eurheartj/eht084
dc.subjectIVUS
dc.subjectstatins
dc.subjectatherosclerosis
dc.subjectrisk factors
dc.titleFactors underlying regression of coronary atheroma with potent statin therapy
dc.typeJournal article
pubs.publication-statusPublished

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